Idiosyncrasy for Anesthesia Induction

**Anesth Meds (IV)

Dormicum
Nubain
Morphine
Valium
Ephedrine
Fentanyl
Demerol
Ketamine

***Basic Meds (IV)

Propofol (2)
Atracrium (2)
Tranexamic Acid 500 mg (2)
Atrophine
Ranitidine
Paracetamol
Ketorolac
Tramadol 100 mg
Diphenhydramine
Promethazine
Epinephrine
Oxytocin (For OB Cases)
Methergine (For OB Cases)

Regional Anesthesia Subarachnoid Block

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(RA-SAB)
Lumbar Area

Positions:
Sitting Position
No torque
Chin on chest
Arms resting on knees
Footstool/Table to support feet

bed

of bed

position

Lateral Position
Shoulders perpendicular to
Positioned with hips on edge
Hugging pillow/knee chest

Things Needed:

Anesth Meds**
Basic Meds***
Spinal Tray #1
Distilled water (vial) #1
Spinal needle G.25 / G.26 (Dr. Perez) #1
Sensorcaine heavy #1
Lidocaine polyamp #1
Alcohol for cleaning the site of induction (Dr. Fullante)

Indications:

Orthopaedic surgery on the pelvis, femur, tibia and the ankle

Hip replacement

Knee replacement
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Hip fracture surgery

Lower limb vascular surgery

Endovascular aortic aneurysm repair

Hernia (inguinal or epigastric)

Haemorrhoidectomy (Piles), fistulae and fissures

Nephrectomy and Cystectomy in combination with general anaesthesia

Transurethral resection of the prostate and transurethral resection of

bladder tumours
Abdominal and vaginal hysterectomies
Laparoscopy assisted vaginal hysterectomies combined with general
anaesthesia
Caesarean sections

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Epidural Anesthesia
(RA EA)

Positions: Same as RA - SAB

Things Needed:

Anesth Meds**
Basic Meds***
Spinal Tray #1
Morphine #1
Isotonic solution (vial) #1
Distilled water (vial) #1
Spinal needle G.25 / G.26 (Dr. Perez) #1
Sensorcaine green #1
Lidocaine polyamp #1
Epidural catheter #1
Micropore 2 inches #1 or leucoplast wide #1 (Dr. Fullante)

Indications:

Normal Spontaneous Delivery (Childbirth): For analgesia alone, where

surgery is not contemplated. An epidural injection or infusion for pain
relief is less likely to cause loss of muscle power, but has to be
augmented to be sufficient for surgery.

As an adjunct to general anaesthesia. The anaesthetist may use

epidural analgesia in addition to general anaesthesia. This may reduce
the patient's requirement for opioidanalgesics. This is suitable for a wide
variety of surgery, for example gynaecological surgery
(e.g. hysterectomy), orthopaedic surgery (e.g. hip replacement), general
surgery (e.g. laparotomy) and vascular surgery (e.g. open aortic
aneurysm repair).

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For post-operative analgesia, after an operation where the epidural

technique is employed as the sole anaesthetic, or in conjunction with
general anaesthesia. Analgesics are administered into the epidural space
typically for a few days after surgery, provided a catheter has been
inserted. Through the use of a patient-controlled epidural analgesia(PCEA)
infusion pump, a person can supplement an epidural infusion with
occasional doses of pain medication through an epidural catheter.

For the treatment of back pain. Injection of analgesics and steroids into
the epidural space may improve some forms of back pain.

For the treatment of chronic pain or palliation of symptoms in terminal

care, usually in the short- or medium-term.
General Anesthesia through Intravenous
(GA IV)

Things needed:

Anesth Meds**
Basic Meds***
Distilled water (vial) #1
GA Mask should be available for possible GA inhalation of Sevoflurane.
Sevoflurane is used to cause general anesthesia (loss of
consciousness) before and during surgery. It is inhaled (breathed in).

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General Anesthesia through Endo Tracheal Tube

(GA ET)

Position: Supine (Head tilt chin lift maneuver during intubation)

Note: IV Bottle can be placed under the neck to aid the Anesthesiologist
during intubation.
Things needed:

Anesth Meds**
Basic Meds***
Laryngoscope with blade (SIZE VARIES)
E.T. Tubes different sizes depending on the gender, age and body
weight of the patient (eg. Ranges from as small as 2.0 for neonate to
as big as 8 for adults)
Distilled water (vial) #1
Leukoplast to secure the E.T. tube
Micropore 1 inch
Aqua Gel (KY)
Surgical gloves (SIZE VARIES)
Stethoscope
Capnograph
10 cc syringe
Succinylcholine (Quelecin)
Isoflurane

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Sevoforane (Computed as standard of 3 x Volume of Sevo x No. of

hours and minutes x No. of oxygen administered in liters per minute)
eg. 3 x 3 x 1.5 hrs x 6 LPM

Ask for the following:

Name and Age
Allergies (Any like drugs, food or even latex products)
Smoker ( If yes, how many sticks or packs per day in average; If
no, when did he/she stop smoking)
Alcoholic drinker ( If yes, how many bottles per day in average,
moderate, heavy or occasional drinker?; If no, when did he/she
stop drinking alcohol)
Comorbidity (From Cardio to Muscolo-skeletal)
Previous Operation and Anesthesia Experience
Any complications from previous anesthesia
Weight
Height
Points to Remember per Anesthesiologist:
Suction Machine should be available and ready to use.
Always prepare double set up (e.g. GA IV and GA ET) for
emergency purposes.
Check anesthesia machine prior to operation.
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Dr. Edralin
Surgical Gloves Size 7.5
Dr. Capiral
Surgical Gloves Size 6.5
Do not hook to oxygen until ordered or as indicated.
Dr. Perez
Pre-meds: Nubain 1 amp + Benadryl 1 amp IM (unless specified)
Surgical Gloves size 7.5
Atrophine should be placed above the anesthesia machine near
the cotton balls.
Spinal needle G.26

Dr. Fullante
Use oxygen face mask instead of nasal cannula
Surgical Gloves size 7
Leukoplast Wide is being used to secure the Epidural Catheter
Dr. Damasco
Surgical Gloves 6.5
Dr. Camille Edralin
Preop Meds: Aloxi 1 amp IV (unless specified)
Surgical Gloves 6.5

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